Parkinsonism-Secondary Version: Symptoms, Causes, and Treatment Approaches
Secondary Parkinsonism, a condition that shares symptoms with Parkinson's disease, can be a potential complication for some individuals. This umbrella term encompasses various movement disorders, characterised by tremors, stiffness, and slowed movements, among other symptoms.
Unlike Parkinson's disease, which has a specific cause, secondary Parkinsonism can be the result of adverse reactions to certain medications or underlying medical conditions. A doctor may perform a physical examination, review a person's family and medical history, and ask about symptoms to diagnose secondary Parkinsonism. Additional tests may be ordered to determine the underlying cause.
One of the most common culprits for medication-induced secondary Parkinsonism are dopamine-blocking agents, such as neuroleptics (antipsychotics) and antiemetics like metoclopramide. These drugs block dopamine receptors and can induce parkinsonian symptoms similar to Parkinson's disease. Dopamine receptor antagonists, including typical and atypical antipsychotics, and metoclopramide are major contributors to this type of parkinsonism.
Treatment for secondary Parkinsonism varies based on the underlying cause. For medication-induced parkinsonism, stopping or replacing the offending medication is often the first step. Anticholinergic medications, medications used for Parkinson's disease like levodopa or carbidopa, may also be prescribed.
For other causes of secondary Parkinsonism, treatments involve addressing the underlying condition. For instance, a brain tumor may require surgery, while normal-pressure hydrocephalus might be managed with a shunt procedure.
A person's outlook depends on the underlying cause of the condition, their age, onset of symptoms, and how well treatments work. In general, drug-induced parkinsonism is usually reversible upon stopping the offending medication, unlike idiopathic Parkinson's disease.
It's important to note that Parkinson's disease is a neurodegenerative condition that affects the nerve cells in the substantia nigra and causes a loss of dopamine, leading to movement issues, stiffness, and tremor. Medical conditions that can cause secondary Parkinsonism include normal-pressure hydrocephalus, brain damage due to a vascular event, repeated head injury, prolonged exposure to heavy metals and industrial toxins, a brain tumor, hypoxia, and certain viral infections like influenza A, Epstein-Barr virus, varicella zoster virus, hepatitis C, HIV, and West Nile virus.
A doctor will have to rule out atypical Parkinsonism, including syndromes like progressive supranuclear palsy and dementia with Lewy bodies. Imaging tests such as CT or MRI scans may be performed to check for vascular lesions, brain tumors, or other abnormalities. In some cases, a dopamine transporter scan may be suggested to check the function of dopamine transporters in a person's brain.
Preventing secondary Parkinsonism is not always possible, but avoiding repeated head injuries can help. This can be achieved by avoiding contact sports or wearing a helmet when there is a risk of head injury.
In summary, secondary Parkinsonism can be caused by adverse reactions to medications or underlying medical conditions. Neuroleptics (dopamine antagonists) and metoclopramide are the most common medications known to cause secondary (drug-induced) parkinsonism. Treatment varies based on the underlying cause and may involve stopping or replacing medications, prescribing anticholinergic medications, or medications used for Parkinson's disease. It's crucial to consult a healthcare professional for accurate diagnosis and treatment.
- Secondary Parkinsonism, a condition similar to Parkinson's disease, can be a complication for some individuals, and it is often associated with neurological diseases and disorders.
- The umbrella term of secondary Parkinsonism includes various movement disorders, such as tremors, stiffness, and slowed movements, that can be the result of adverse reactions to certain medications or underlying medical conditions.
- Notably, drug-induced secondary Parkinsonism is frequently caused by dopamine-blocking agents, like neuroleptics and antiemetics, which block dopamine receptors and induce parkinsonian symptoms.
- The outlook for secondary Parkinsonism patients largely depends on the underlying cause, age, onset of symptoms, and how well treatments work, with drug-induced parkinsonism typically being reversible upon stopping the offending medication.
- It's important to note that Parkinson's disease is a specific neurodegenerative condition affecting nerve cells, whereas secondary Parkinsonism can be caused by various medical conditions, such as normal-pressure hydrocephalus, brain damage, and certain viral infections.
